Oral β-Lactam Pairs for the Treatment of Mycobacterium avium Complex Pulmonary Disease

Abstract

Cure rates for pulmonary disease caused by the Mycobacterium avium complex (MAC) are poor. While beta-lactam are front line antibiotics against Mycobacterium abscessus pulmonary disease, they have not been used or recommended to treat MAC lung infections. Through a comprehensive screen of oral beta-lactams, we have discovered that selected pairs combining either a penem/carbapenem or penicillin with a cephalosporin are strongly bactericidal at clinically achieved concentrations. These dual beta-lactam combinations include tebipenem and sulopenem, both in phase 3, and Food and Drug Administration-approved amoxicillin and cefuroxime. They could therefore immediately enter clinical trials or clinical practice.